Publication details

Visual presentation of clinical practice guidelines, representations of the strength of recommendations and the certainty of evidence and their transformation to GRADE

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Authors

KLUGAR Miloslav KANTOROVÁ Lucia POKORNÁ Andrea LÍČENÍK Radim DUŠEK Ladislav SCHÜNEMANN Holger J RIAD Abanoub KANTOR Jiří KLUGAROVÁ Jitka

Year of publication 2021
Type Appeared in Conference without Proceedings
MU Faculty or unit

Faculty of Medicine

Citation
Description Background Organizations dedicated to the development of clinical practice guidelines from around the world have been using a range of systems to rate the certainty of evidence (CoE) and strength of recommendations (SoR), each of which has its own symbols and overall visual form. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system has been increasingly adapted by these organizations, however, even when using GRADE, authors of guidelines have so far been left free to choose from a few options for depicting the CoE and SoR and the visual form of presenting recommendations that best suit their needs. Objective The objective of this paper is to propose an approach to visual unification of adapted guidelines and transformation of classifications of CoE and SoR into the approach suggested by the GRADE working group. Methods We carried out a literature search in MEDLINE and Epistemonikos, an analysis of selected guidelines, and an iterative discussion to decide on a consistent visual presentation and CoE and SoR depictions. Results The results of the literature search suggested this issue had not been addressed yet. The analysis of eight selected guidelines showed significant heterogeneity in the visual presentation of recommendations. Recommendations were often worded similarly to whether or not they were strong or conditional. Discussion We proposed an approach for transforming recommendations that are being adapted and which use various classification systems for CoE and SoR into GRADE and a consistent visual style.
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